Remote Nurse Informaticist — Interoperability & Policy Lead

State of Washington; Olympia (WA); Remote; USD 120,000 - 170,000; Full time

Benefits offered by this job

Remote work with flexible schedules

Paid vacation & holidays

Comprehensive benefits package

Job summary

Washington State Health Care Authority seeks a Clinical Nurse Specialist (Nurse Informaticist) to lead the integration of clinical informatics into Medicaid prior authorization workflows. This remote, full-time role supports policy, data standards, and system design to ensure medically necessary care is delivered efficiently.

You will collaborate with clinical, technical, and policy teams, keep current with CMS/WAC regulations, and support legislative requirements while enjoying flexible

Qualifications

• Active, unrestricted Washington State Registered Nurse license or Multi-State License.
• Interoperability & HIT: APIs, HL7, FHIR standards.
• EHR integration: align provider EHRs with state payer databases.
• Workflow automation: open nonproprietary workflows to reduce admin burdens.

Responsibilities

• Lead implementation of information exchange for prior authorization API and data standards.
• Coordinate with divisions, payers, and EHRs to identify documentation requirements for automated data exchange.
• Configure Medicaid policies into payment systems and advise on interoperability initiatives.
• Represent WA Medicaid in CMS rulemaking and forums like WEDI.
• Perform utilization reviews and make authorization/claim determinations per policy.

Job description

Washington State Health Care Authority seeks a Clinical Nurse Specialist (Nurse Informaticist) to lead the integration of clinical informatics into Medicaid prior authorization workflows. This remote, full-time role supports policy, data standards, and system design to ensure medically necessary care is delivered efficiently.

You will collaborate with clinical, technical, and policy teams, keep current with CMS/WAC regulations, and support legislative requirements while enjoying flexible